Dialysis delivery in children on nightly intermittent and tidal peritoneal dialysis
Nightly intermittent peritoneal dialysis (NIPD) is an automated form of intermittent peritoneal dialysis which has potential medical and psychosocial advantages in comparison with CAPD/CCPD due to the lack of daytime exchanges. Data on solute/water removal in children on NIPD are nevertheless scarce, so that no clear indications for NIPD can yet be formulated in pediatric age. For this reason, 12 patients, mean age 10.49 +/- 5.81, mean body weight 23.73 +/- 10.92, with a residual creatinine clearance 1.70 +/- 2.30 ml/min/1.73 sqm, on NIPD for 14.7 +/- 5.4 months, underwent clearance studies over 3 days. Mean dialysis infusion volume was 460.08 +/- 196.30 ml/kg/day, with 10.33 +/- 1.22 h dialysis time. Peritoneal creatinine and urea clearances were 6.36 +/- 2.96 and 8.49 +/- 3.35 1/day/1.73 sqm, respectively. Combined creatinine and urea clearances averaged 6.12 +/- 2.21 and 6.96 +/- 2.16 ml/min/1.73 sqm, resulting in serum creatinine and urea values of 7.78 +/- 1.90 and 115.58 +/- 29.93 mg/dl, respectively. Ultrafiltration rate was 16.94 +/- 16.34 ml/g glucose absorbed. NIPD provided similar or improved solute and water clearances compared with those reported in children and adults on CAPD/CCPD, without inconvenient long periods in bed. These data indicate that NIPD is a suitable treatment in pediatric end-stage renal disease.